Practicum analysis

During my practicum, I was given the case of a patient who was experiencing significant abdominal pain.

The 45-year-old man arrived with diarrhea, nausea, and vomiting over the previous two days. The patient has been smoking one pack of cigarettes each day for the past 28 years and has no history of substance abuse. Furthermore, the patient had Crohn’s disease, HTN, PST, and bipolar disorder, as well as an allergy to penicillin and morphine. The patient was given fentanyl 50mcg IVP, 12.5 mg dilute Phenergan, and Mg sulfate IVP upon arrival.

The results of the examination revealed that the stomach pain was most likely caused by a Crohn’s disease flare.

The condition affects different parts of the gastrointestinal tract and can cause bleeding, ileitis, and abdominal pain. It can be treated with various medications that can induce immunosuppression among them ASA drugs, steroids and immune modulators (Ali, Martin, Rao, & Kiran, 2014). In this case, the patient was prescribed prednisone 60mg for two weeks. Some of the symptoms like diarrhea and vomiting had subsided by admission, but the nausea was to be treated with Phenergan if it persisted.

Further, the patient was to continue with his Crohn’s medication

and since he had diabetes, he was started on a diet restricted in sugars and fat. However, he was to consume a daily balance of carbohydrates, proteins, and fats that would provide the essentials nutrients needed for his condition. Lastly, his electrolytes and hydrates with fluids were to be monitored if the need arose. The case demonstrated that Crohn’s disease can be asymptomatic sometimes but when exacerbated the patient is likely to experience fever, acute abdominal pain, nausea, vomiting, and diarrhea. Therefore, people with a history of the disease should avoid smoking and other risk factors to prevent an early postoperative relapse.

References

Ali, U. A., Martin, S. T., Rao, A. D., & Kiran, R. P. (2014). Impact of preoperative immunosuppressive agents on postoperative outcomes in Crohn’s disease. Diseases of the Colon & Rectum, 57(5), 663-674.